Electronic cigarettes — embraced by users as a healthier alternative to smoking or a good way to quit — are picking up steam.

There’s little research on how safe they might be or whether they’re an effective strategy for kicking the habit, but more people are giving e-cigarettes a try every day.

About one in five adult cigarette smokers in the U.S. had tried electronic cigarettes in 2011, nearly twice as many as in 2010. Sales reached nearly $500 million in 2012 and are expected to double to $1 billion this year. As the market grows, even tobacco companies are jumping on board.

R.J. Reynolds Vapor Co. launched its Vuse electronic cigarette this summer in Colorado. Altria Group Inc., parent company of the nation’s largest cigarette maker, Philip Morris USA, will soon debut its product, MarkTen, in Indiana.

Electronic cigarettes, or e-cigarettes, are a smoke-free alternative to the traditional paper cigarette. The most basic version, one that could be mistaken for an actual cigarette, is comprised of a liquid cartridge attached to a white cylinder containing a battery.

The battery heats the liquid into a vapor that the user inhales. Instead of smoking, it’s come to be called “vaping.”

The liquid is a mixture of propylene glycol (a common chemical used in many in food products), vegetable glycerin, flavoring and nicotine. The composition can vary greatly by manufacturer.

Typical electronic cigarettes range from around $10 for a standard e-cigarette that requires replacement liquid cartridges to as much as $70 for a polished wooden model that can be refilled.

Although prices vary, pre-filled liquid cartridges, each lasting about as long as a pack of cigarettes, usually cost a few dollars, and bottles of flavored e-liquid range from a few dollars to more than $10 depending on size.

But as the market grows, little conclusive research has been done to determine the health effects of inhaling a nicotine-laced vapor.

The e-liquids themselves are not required to meet any federal standards, although the FDA is expected to exercise its regulatory authority over the products later this year.

Approval by the FDA means that a nicotine product, such as a patch or gum, has met standards of safety and effectiveness, said Dr. Anne Joseph, a tobacco researcher at the University of Minnesota. For now, e-cigarettes are in a gray area and are not regulated as tobacco products or medical devices, even though they share similarities with both product categories.

Joseph adds that electronic cigarettes may not be all bad for current tobacco users, with a couple of important caveats: Nonsmokers shouldn’t start, and e-cigarette consumers should use them only with the goal of quitting.

There’s a lot scientists still don’t know. That includes the actual chemical exposure that users receive compared with traditional smokers’ intake; the way vaporized nicotine is absorbed by the body; and the effects of secondhand vapor.

“States and local governments are having to revisit clean indoor air laws, and that’s important for a couple reasons,” Joseph said. “One, we don’t know what they are emitting into the air.”

Also, she worries that use of e-cigarettes will undermine years of antismoking campaigns that have taken cigarettes out of public places.

Compared with traditional cigarettes, electronic cigarettes appear to have fewer toxins, but the impact of e-cigarettes on long-term health must be studied, the Centers for Disease Control and Prevention said in February.

“E-cigarette use is growing rapidly,” Dr. Thomas Frieden, director of the CDC, said in a statement at the time. “There is still a lot we don’t know about these products, including whether they will decrease or increase use of traditional cigarettes.”

Katie Forster, who had tried to quit smoking with nicotine gum and patches, recently bought an e-cigarette.

“I did a lot of research” about the safety, said Forster, 26, who works for an accounting firm uptown. “And if I’m picking between a cigarette and an (e-cigarette), it’s the lesser of the two evils for me.”

Forster, who said she’ll stick with it until she can quit smoking completely, chose a more elaborate device with a rechargeable battery and a refillable liquid cartridge.

The liquid is available in hundreds of flavors with varying levels of nicotine. It’s those flavors, with appealing names such as Mocha Madness, Cotton Candy, Bourbon, Cowboy and Cuban Supreme, that have been a point of contention for some who worry that teenagers may be enticed. And for now, there is no federal restriction on the sale of e-cigarettes to minors.

But a North Carolina state law prohibiting the sale of electronic cigarettes to minors went into effect Thursday.

Unlike smoking, which is banned in North Carolina bars and restaurants, e-cigarettes are allowed at a business owner’s discretion. But observers of the bar scene in Charlotte say they aren’t too common yet. A statewide trade group for restaurants and hotels says electronic cigarettes haven’t been an issue among its members.

As questions about the safety and regulation of e-cigarettes linger, some North Carolina entrepreneurs are beginning to self-regulate ahead of state and federal agencies.

Joe Wofford, the owner of Volcano of Raleigh, an electronic cigarette shop that opened in late 2012, says his average customer is a 40-year-old woman who smoked cigarettes for 20 years before deciding to make the switch. Wofford said his shop, also known as The Puffing Monkey, doesn’t sell to anyone younger than 19.

MadVapes, a manufacturer of electronic cigarettes based in Mooresville, began as a home office operation in 2009 and has now expanded to fill 30,000 square feet of warehouse space and run four Charlotte-area retail locations.

Four years ago, owner Mark Hoogendoorn, a computer programmer by trade, took his first online order. It all began when Hoogendoorn, a smoker himself who tried to quit for at least 20 years, puffed on an electronic cigarette and decided that he could do better. Today, his company has about 60 employees and ships as many as 600 online orders a day.

“We’re trying to be a really responsible company,” said Hoogendoorn, 51, of Denver, N.C. “I would personally like to see some sort of regulation on how e-liquid is manufactured.”

MadVapes follows e-liquid production standards set by a volunteer trade organization that aims to “promote safety and responsibility through self-regulation.”

Hoogendoorn said his company periodically sends batches of its e-liquid to a lab in Raleigh for chemical analysis.

Scientists and medical professionals, meanwhile, continue to offer the following caution: Long-term health effects of electronic cigarettes are unknown, and it could be years before consensus is reached about their safety.

I love the witch hunt logic of so called experts, For example:
Dr. Anne Johnson - "Also, she worries that use of e-cigarettes will undermine years of antismoking campaigns that have taken cigarettes out of public places." Well, its a proven fact that e-cigarettes pose no second hand health hazards as tobacco reputedly does". I say reputedly because the World Health Organizations indepth study of second hand smoke concluded there was no provable health risks to second hand smoke.
Then an outright lie from Dr. Thomas Frieden. A Director at the CDC, said in a statement at the time. “There is still a lot we don’t know about these products, including whether they will decrease or increase use of traditional cigarettes.” Overwhelming evidence from millions of users that electronic cigarettes greatly reduce or completely eliminate tobacco usage in their lives. This guy is a doctor and he doesn't know this. LMAO
And as far as safety of the product is concerned, China exports 1000's of food products, drugs and edible base materials to the United States and none of it is scrutinized by the Food & Drug Administration. But the FDA is all prepared to regulate U.S. manufactured e-juice. If the FDA is so concerned with the publics safety, why do the Chinese products escape their scrutiny. Can you pronounce h.y.p.o.c.r.i.t.s and also selling out to big tobacco lobby who have the deep pockets to operate these pharmaceutical level mixing labs. Welcome to exhorbitant prices and more tax revenues for governments both federal and state.
So now you know why the FDA wants this industry regulated.
My qualifications to comment,
My qualifications to comment,
B.A. in Public Administration (it's a specialized degree in government administration and function)
Medical Corp - U.S. Navy

Mark J wrote:

08/13/2013

Of course electronic cigarettes is more than just hot air. But there's more to it than just hot air. Many of the electronic cigarettes contain nicotine and it might actually depend on people to decide which nicotine strength should they opt for and sometimes this becomes an issue. I mean, instead of lowering their nicotine intake, those who do not know their current nicotine dosage could sometimes choose a much higher nic str. And even though nicotine by itself is not considerably carcinogenic and instead it is a stimulant, even that has a limit. Don't get me wrong, I'm also a vaper. What I'm simply trying to say is that if one has the desire to switch to e-cigs, they have to take responsibility and also regulate it. Still, I have no doubt that e-cigarettes is indeed the future, a revolutionary alternative to smoking - once you're into e-cigs, the chances of going back to regular smoking is very small as it makes traditional smoking taste nasty.
Oh and I can't believe that the owner of Madvapes started to be a smoker then switched to vaping too! His story is inspiring for us small businesses specially engaged in e-cigs. And like him, we saw a potential in the e-cigarette industry. My friends and I are teamed up, working together on this online business for more than a year now. Our site is http://www.clickacig.com, we hope to be successful just like Mark Hoogendoorn, the owner of madvapes. An advice from him would be nice.. :p

RichardBrunswick wrote:

08/13/2013

E-cigarettes are here to stay. There are pros and cons related to them. Reportedly, many regular smokers have replaced regular cigarettes with e-cigarettes and likely are far better off health-wise from this change. Whether e-cigarettes will lead to weakening of anti-smoking regulations or serve as a "gateway" drug such that young people will begin with e-cigarettes and "graduate" up to regular smoking is unknown. The nicotine solution used with e-cigarettes is a potential serious poisoning hazard for young children who might ingest it. Manufacturing standards are lax; many brands and solutions are made in China and the potential for contamination exists.
Nevertheless, for the individual smoker who has been unable to quit after numerous attempts at stopping, the change to e-cigarettes is likely to provide great health benefits as compared to continued smoking of regular cigarettes. Many studies are underway and additional information will be coming out over the next several years.
I discuss e-cigarettes and other alternative nicotine products in my book entitled: Can't Quit? Bullsh*t! You Can Stop Smoking. It is available at local bookstores and on Amazon.
Richard Brunswick, M.D., M.P.H.